Provider Demographics
NPI:1750376133
Name:JSAS HEALTHCARE, INC.
Entity type:Organization
Organization Name:JSAS HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY EXECUTIVE/COO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:732-988-8877
Mailing Address - Street 1:685 NEPTUNE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4118
Mailing Address - Country:US
Mailing Address - Phone:732-988-8877
Mailing Address - Fax:732-988-2572
Practice Address - Street 1:685 NEPTUNE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4118
Practice Address - Country:US
Practice Address - Phone:732-988-8877
Practice Address - Fax:732-988-2572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0405X
NJ41340261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0102806Medicaid
NJ7632801Medicaid